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14079 POST THIS CARD NEAR FRONT OF BUILDING CITY OF CUPERTINO PERMIT NUMBER 14079 INSPECTION DIVISION JOB INSPECTION RECORD PERMIT EXPIRATION JOB ADDRESS 22646 OAKCREST CT UNIT# _LOT# PERMIT EXPIRES IF WORK OWNER ALBERT SEID CONTRACTOR RICHARD ARCELIGA IS NOT STARTED WITHIN INSPECTION DATE INSPECTOR INSPE TION RECORR 180 DAYS OF PERMIT ISSU. FOUNDATION fl_Zs-(3$ 1 yA A.— OR 180 DAYS FROM UFER "DI COyvvsa�p,� 7'0 ASTCALLED INSPECTION. PREGUNTE PERMIT VALIDATION Z POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB • `� '" PLUMBING ELECTRICAL -IMSDANCE DArE MECHANICAL ,BLn .. -ELECT. PLC .e MECH. El' ❑ El Y o DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT INFORMATION PLUMBING ALunnoN WOOD FLOOR vSIFT. MECHANICAL PERMIT TO ELECTRICAL - _ FRAMING + STORIES TYPE CONSTR. INSULATION OCG GROUP RES.UNITS ^ri'•sN;,;\ PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED SO FT.FLoor+AREA TOTAL ACREAGE ROOF / DIAPHRAGM eulLmrvc USE RES IND CON PB Omer El 1:1 APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED ASSESSORS PARCEL NO, ROU PLUMBING2-4 Wt TRACT NO. PARCEL NO GAS TEST MECHANICAL ELECTRICAL FINALS DATE INSP. ACC.DATE ACC.FILE NO. FRAMINGTX* jaila SAN # ZONING ENG.SITE NO. INSULATION PLUMBING GAS MECHANICAL FIRE SPRINK ENERGY 1-24 v ED NO v cl No COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING LATH-INTERIOR ELECTRICAL FLOOD ZONE A,L.U.C. LATH-EXTERIOR FIRE DEPT. Y[] N[] Y0 N❑ SHEETROCK GRADE FEE SUMMARY SHEAR INTERIOR BUILDING BUILDING SHEAR EXTERIOR TEMPORARY AP OVAL FIREWALLS ELECTRIC PLAN CHECK FEE GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED JOCCUPANCY SEISMIC FEE OCCUPANCY OF BUILDING IS NOTPERMITTED UNTIL BUILDING FINAL ISSIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC Lu ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. — SEE PERMIT FOR EXPIRATION DATE — MECHANICAL IMPORTANT! CONST.TAX PLEASE READ REVERSE SIDE BEFORE TOTAL / CALLING FOR FINAL INSPECTION. OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY • r 'BUILDING PROJECT IDENTIFICATION PERMIT NUMBER AU'LDIN APPLICATION & PERMIT DDRESS O G+ BUILDING- ELECTRICAL-PLUMBING-MECHANICAL 14079 OWNER'S PLAN CHECK VALIDATION 1 "A QTY. ELECTRIC PERMIT FEE SL+ % v"oNE CONTRACTORS J UTLETS-SWITCHES-RECEP 10.00/1.00 3 - AME / Ar A ZI r c.NCP_ 98 IGHTING FIXTURES 10.00/1.00 Id \J' AcroR'sADDEESS Q/ (f bMu QA6 cc,/ APPLIANCES-RESIDENTIAL 4.00 S J0 J 27 pRONEp, q5 -ZPANELS IO.00 DATE OF APPLICATION ARCHITECT PANELS (OVER 200 AMP) 20,00 PLAN CHECK FEE P.C.NO. OR ENGINEER LIC.No, SIGNS TRANS. 3.00 ARCR.SS Ervc. SPECIAL CIRCUIT 5,00 PERMIT VALIDATION ESS ADDR ZIP TEMP.METER OR POLE INS. 20.00 , APPLICANT'S'O7 / / //,/ I MOTORS SEE FEE SCH. ADDRESS 1J 10 /I V O '30-ft n /� Z SERVICE CHANGE 20.00 w o o LICENSED CONTRACTORS DECLARATION ^ r �a/��J <is u I hereby uffrin that 1 am licensed under provisions of Chapter 9 r n• nnnpr`•n(1 IsgtlANEEsBATE?0 N z w (commencing with Section 7000)of Division 3 of the Business and BLDG. ELECT. - PLG. MECH. F w z Professions Co and my license is in full for a dgife ® rl z O m - License Class Lic.Number_ 9 }� 9 z L° Dale - Contrecto a y f_t BUILDING PERMIT ¢ ¢w a OWNER-BUILDER DECLARATION INFORMATION X °u N I hereby affirm that I am exempt from the Contractor's License MISC.- REFER TO ORD Y P VALUATION $/FT. Law for the following reason.(See.7031.5,Businessand Professions PERMIT ISSUANCE 10.00 O Code:Any city or county which requiresa permit to construct,ager, %6 le ¢ Q improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. or ° ¢ requires Mc applicant for such ELEC. 4 _'J 0�J I pp permit to file a signed statement that TOTAL V a] PERMIT T A w m u- he is licensed pursuant to the provisions of the Contractor's License H z a Law(Chapter 9(cometencinywith Section 7000)of Division 3 ofthe A 4 ° Business and Professions Code)or that he isexempt therefrom and QTY. PLUMBING PERMIT FEE ¢r$ the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. by any applicant for a permit subjects the applicant to a civil penalty ALTER-DRAIN -WATER IEA.) 5.00 of not more than five hundred dollars($500).): ❑ I,as owner of the Property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec. 7044. Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 �\ Code:The Contractor's License Law Joes not apply to an owner of property who builds or improves thereon,and who docs such work FIXTURES-PER TRAP S.OD SPT FT FWOR AREA TOTAL AC(CAGE r himselfre tat intthhisoroemred I.,Sale.If,ed Imwalsuch improve. lding GAS-EA.SYSTEM-1 6.00 "T menus are not intended or offered y sale.11',mpleveq the building or improvement will have is sob within one year of he didtio t the Owner- builderrim. GAS-EA.SYSTEM-OVER 4 (EA.) 2.00 BUILDING USE will have the burden of proving that he did not M1uild or im RES IND CON PB Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ as owner of the property, exclusively contracting with ❑ El ❑ F-1 dd contractors to construct thehe project(Sec.. 70 7044,Business LAWN SPRINKLERS-1 INC 5 V.B. 6.00 ASSESSORS PARCEL No. and professions Code:The Contractor's improv Law does not apply to tr owner of properly who milds tr improves thereon.and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such License with a ttmlrackn(s)licensed pursuant to the Comractor's Liccnsc Law. SEWER-SANITARY-STORM EA'.200ft110.00 TRACT No. PARCEL No. ❑ tum exempt under Sea ,B.&P.C.I'or this WATER HEATER W/VENT 6.99 "r•inn reason Owner Date WATER SYSTEM • 5.00 ACC.DATE ACC.FILE NO. W'ORKERS'COMPENSAT'ION DECLARATION WATER TREATING EQUIP. 5.00 I hereby affirm that I have a Certificate of consent to self-insure, ZONING ENG.SITE NO. or a certificate of Workers'Conmcheation Insurance,or a certified copy thereof(Sec.3800,Lah.C.L Policy No. C'anpany O ❑ Certified copy is hereby furnished. FIRE SPRINK ENERGY T 24 I ❑ Certified copy is filed with the city inspection division. MISC.- REFER TO ORD. o� APPlirnu Y❑ N❑ Y ❑ NO c w CERTIFICA'IT OF EXEMPT'ION PROM WORKERS' PERMIT ISSUANCE 10.00 Q- FLOODZONE A.L.U.C. LLI >_ COMPENSATION INSURANCE, PLG.CONTR. LIC.No. TLG OTAL �Q - ❑ ❑ ❑ ❑ EL O (This section need not be completed if the permit is for one v N v N ::) Z hundred dollars(S 100)or less.) U O I certify that in the performance of the work for which this perOTY MECHANICAL PERMIT FEE FEE SUMMARY LL f mit is issued.I shall not employ any person in any manner so as to U becie ssubjcct to Wofkerss�' .lion Cahl' niu. BUILDING 0A 's U n Uat' plicnn _� ALTER OR ADD TO MECH. 5.00 NO'1'ICIi TO APPLICANT: 11',alter making this crtl ma u lix- rZ emptier,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK J? provisions of Bre Labor Code, you must forthwith comply with FEE S_ 3 U such provisions or this permit shall be deemed revoked. AIR HANDLING UNIT(TO 10)000C.F,M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER io=C.F.M.) 6.00 SEISMIC FEE 7Q 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD (WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. HEATING UNIT(TO 100,000 B.T.U.) 8.00 MICROFILM 3097,Civ.C.). Lender's Name HEATING UNIT(OVER l00,000B.T.U.)9.50 ELECTRIC 33 !Z - Lender's Address I certify that I have read this application and state that the above VENTI LATION•FAN (SINGLE) 4.00 information is correct. I agree to comply with all city and county BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 PLUMBING ordinances and state laws relating to building construction, and / hereby authorize representatives of this city to enter upon the BOILER-COMP (Over 100,000 BTU)SEE FEE SCH. MECHANICAL SJ�f_above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. Cupertino against liabilities,judgments, costs and expenses which Q __ CONST.TAX may in any way accrue,against said City in consequence of the PERMIT ISSUANCE10.00granti0 a permit, MECH.CONT. LIC.N0. If -ZZ-B TOTAL S`7 TOTAL a Signature of AppicentlContractor Date OFFICE COPY